卡托普利含服治疗高血压急症30例疗效观察

高血压急症病人需降压,静脉给药须专人监护,很不方便,我们用卡托普利舌下含服治疗30例高血压急症患者,疗效满意,现将结果报告如下：     

硝苯地平和开博通舌下含服治疗高血压亚急症的疗效观察

目的观察硝苯地平和开博通舌下含服治疗高血压亚急症的疗效。方法硝苯地平联合开博通舌下含服治疗49例高血压亚急症患者。结果硝苯地平联合开博通治疗高血压亚急症有效。结论硝苯地平和开博通舌下含服治疗高血压亚急症的疗效明显,无明显副作用,给药途径方便、治疗费用便宜,可在基层推广使用。     

60例舌下含服尼群地平治疗高血压急诊疗效观察

对60例舌下含服尼群地平的高血压急诊患的临床疗效和其安全性的研究,该药降压迅速、安全可靠,总有效率达96.66%.含服5min起效(P<0.01),60min的降压作用最显,降压作用达6h.     

含服卡托普利治疗高血压急症的疗效观察

目的：给高血压急症患者含服卡托普利片治疗,并与肌注利血平治疗作对照,找出快速有效的降压药物。方法：含服卡托普利片３７．５ｍｇ治疗高血压急症３０例,３０例用利血平针１ｍｇ肌注作对照。结果：含服卡托普利片１５ｍｉｎ后却开始有显著的降压作用（Ｐ〈０．０１）,３０、６０、１２０ｍｉｎ后降压效果更显著（Ｐ〈０．０１）;利血平股注治疗组１５ｍｉｎ后血压无明显下降（Ｐ〉０．０５）,３０、６０、１２０ｍｉｎ血夺下降显著（Ｐ〈０．０１）。组间比较,含服卡托普利降压作用明显（Ｐ〈０．０１）。结论：卡托普利含服是治疗高血压急症较有效的方法。     

舌下含服卡托普利治疗高血压病急重症的研究

目的 寻求一种用于急重症高血压的安全、有效的降压药物。方法 入选急、重症高血压患者 83例,随机分成舌下含服卡托普利组和硝苯吡啶组,观察血压、心率、心电图、临床症状及不良反应等。结果 2组血压下降程度无显著性差异,而两组间心率变化有显著性差异(P <0.005)硝苯吡啶诱发心绞痛 4例。结论 舌下含服卡托普利治疗高血压重 ,症是安全、有效的。     

Dose-response effect of sublingual captopril in hypertensive crises

Forty-one patients, presenting in the Emergency Service of the Hospital General y Clinico, Tenerife, with symptoms of hypertensive crisis and supine diastolic blood pressure (DBP) greater than 120 mm Hg, were studied. They received 12.5 mg of sublingual captopril and 30 minutes later, if diastolic blood pressure (DBP) was not 100 mm Hg or less, the same dose was repeated by the same route. Supine systolic blood pressure (SBP), DBP and heart rate (HR) were monitored at 0, 5, 10, 15, 30, 45, 60, and 120 minutes after each administration of captopril. In 27 patients (66%) had a satisfactory response (DBP less than or equal to 100 mm Hg), after a single dose, less than 30 minutes after administration, which persisted at 120 minutes. In 14, a second administration was necessary after 30 minutes, and a satisfactory response to the second dose, defined again as DBP reaching values of 100 mm Hg or less, was achieved in 12 of them (29% of the total group). In two patients (5% of total) no full response was obtained. The observed pattern of response suggests that a sublingual dose of 25 mg of captopril is the minimum effective dose, but it is also possible that administration of 12.5 mg of sublingual captopril at 10 to 15 minute intervals, perhaps up to a maximum dose of 37.5 mg, might be considered as an alternative treatment in hypertensive crises.     

硝苯地平舌下含服致老年高血压急症患者低血压

1例82岁女性患者,因高血压急症给予舌下含服硝苯地平10mg。20min后患者出现乏力,心慌,四肢冰冷、面色苍白。BP80/50mmHg,P110次/min。心电图检查示窦性心动过速。给予扩充血容量、心电监护及其他对症支持治疗。20min后BP120/70mmHg,乏力、心慌等不适感逐渐缓解。次日,患者血压再次升高,再次给予舌下含服硝苯地平,上述症状再次出现,经对症治疗后好转。     

Comparison of sublingual captopril and sublingual nifedipine in hypertensive emergencies

Hypertensive crises require immediate therapy, usually by parenteral drug administration. Sublingual nifedipine has been shown to be highly effective. However, the blood pressure fall following nifedipine is frequently associated with side-effects. The use of sublingual captopril has recently been indicated in hypertensive crisis, assuming that by this route, there would be a faster absorption and thus a more rapid effect on blood pressure than with the oral route. To verify this hypothesis, we have compared the hypotensive effects of sublingual nifedipine and sublingual captopril in 52 patients with hypertensive emergencies: 25-mg captopril and 10-mg nifedipine were administered sublingually to 28 and 24 patients, respectively. Blood pressures and heart rates were continuously measured up to 240 min postdose. A significant (P less than 0.001) hypotensive effect of both sublingual captopril and nifedipine therapy occurred at 5 min and persisted for 240 min. Heart rates increased with nifedipine, but decreased with captopril. We observed no side-effects in the captopril group, but flushing, tachycardia and headache were observed in 6 patients in the nifedipine group. We conclude that sublingual captopril is effective in patients with hypertensive emergencies and that captopril may be an excellent alternative to sublingual nifedipine in the urgent treatment of hypertensive crisis.     

妊娠期高血压疾病的产科治疗效果观察

目的 探究妊娠期高血压疾病的产科治疗效果观察.方法 回顾性分析2010年5月～2012年5月本院收治的40例妊娠期高血压疾病患者产科治疗的临床资料.结果 本组研究中行剖宫产为75.00%,明显高于阴道分娩的25.00%;重度子痫前期伴有低体重儿的窒息率和死亡率,均明显高于轻中度子痫前期且新生儿体重正常,P均＜ 0.05.无孕产妇死亡病例,有15例（占37.5%）发生并发症.所有患者产后7 d~1个月内临床症状均消失.结论 常规基础治疗妊娠高血压疾病后,可根据患者临床情况,适时给予终止妊娠治疗,有利于降低母胎围生期死亡率,改善母婴预后质量,值得临床应用和推广.     

拉贝洛尔对高血压急症疗效的Meta分析

目的利用Meta分析方法评价拉贝洛尔对高血压急症的疗效与安全性,为临床安全合理用药提供参考。方法以拉贝洛尔、高血压急症为关键词,计算机检索中国数据库,按纳入标准选取拉贝洛尔治疗高血压急症的随机对照试验,用Meta分析方法,运用Rev Man 5.2软件对纳入文献进行分析。结果共纳入5篇文献,Meta结果显示,拉贝洛尔与对照降压药的不良反应也没有明显差异。结论拉贝洛尔对高血压急症患者有明显的降压作用,降压效果和不良反应与对照降压药基本相同。     

丁丙诺啡舌下含片维持治疗海洛因依赖者初步观察

丁丙诺啡是阿片受体的部分激动剂 ,具有强效镇痛作用 ,同时也可用于阿片类依赖的替代治疗 ,包括脱毒和维持治疗。从理论上来说 ,丁丙诺啡用于维持治疗有诸多优势 :(1)它可以激动阿片受体 ,缓解阿片依赖者的戒断症状 ;(2 )由于受体亲和力高 ,在它占据了阿片受体之后 ,其它阿片激动剂就难于与受体结合发挥效应 ,临床表现为在使用丁丙诺啡治疗后再使用海洛因会觉得欣快效应减弱 ,从而逐渐淡化对海洛因的渴求 ;(3)由于与受体解离慢 ,所以作用时间很长 ,可以每天用药 1次甚至 2 - 3ｄ用药 1次 ;(4 )丁丙诺啡的阿片效应与剂量的关系有封顶效应 ,这…     

探讨急诊绿色通道在抢救高血压脑出血患者中的应用效果

目的探讨急诊绿色通道在抢救高血压脑出血患者中的应用效果。方法选取我院2016年1月~2017年6月收治的高血压脑出血患者110例,按照随机数字表法将患者分为院前急救组和非院前急救组,且按照抢救时间划分,抢救时间在1h内的患者有36例,1~5h的患者45例,5h以上患者29例,对比分析两组患者死亡率及不同抢救时间下抢救结果对比。结果院前急救组患者死亡率为10.9%,非院前急救组患者死亡率为38.18%,经统计学对比分析,差异有统计学意义(P<0.05),抢救时间在5h以外患者的死亡率最高,为48.27%,其次为1~5h,死亡率为22.22%,最后为1h以内,死亡率为5.55%,三组比较,差异有统计学意义(P<0.05)。结论急诊绿色通道能够更好的抢救高血压脑出血患者,抢救效果较好,临床应用价值较高。     

Parenteral chlorpromazine and frusemide: safe and effective treatment for hypertensive emergencies

Summary

Hypertensive emergencies present a difficult problem of management. Although many treatment regimens have been described over the years, their application has presented problems of adverse effects and all have required detailed and intensive supervision of patients. After favourable results obtained in a preliminary study using a combination of parenteral chlorpromazine and frusemide, a 5-year prospective study was conducted using this treatment to produce rapid reduction in blood pressure in patients with acute onset severe hypertension (blood pressure greater than 225/130 mmHg). The patients involved covered a wide range from 22 to 74 years (mean 47 years) and, on subsequent or previous investigation, were all considered to have essential hypertension. Twenty-seven patients were treated successfully with a single administration of the regimen. Two women required a second treatment before adequate control of blood pressure was achieved and 1 man died of extensive dissecting abdominal aortic aneurysm before the effects of the therapy could be fully assessed. The reduction in blood pressure was gradual but progressive over 4 hours and the pattern of response was uniform. No significant adverse effects related to the treatment were found. Only basic measurement of pulse and blood pressure was considered necessary and so this regimen of therapy is suitable for general use even when sophisticated monitoring facilities are not available and staff levels are limited.     

Parenteral chlorpromazine and frusemide: safe and effective treatment for hypertensive emergencies

Hypertensive emergencies present a difficult problem of management. Although many treatment regimens have been described over the years, their application has presented problems of adverse effects and all have required detailed and intensive supervision of patients. After favourable results obtained in a preliminary study using a combination of parenteral chlorpromazine and frusemide, a 5-year prospective study was conducted using this treatment to produce rapid reduction in blood pressure in patients with acute onset severe hypertension (blood pressure greater than 225/130 mmHg). The patients involved covered a wide range from 22 to 74 years (mean 47 years) and, on subsequent or previous investigation, were all considered to have essential hypertension. Twenty-seven patients were treated successfully with a single administration of the regimen. Two women required a second treatment before adequate control of blood pressure was achieved and 1 man died of extensive dissecting abdominal aortic aneurysm before the effects of the therapy could be fully assessed. The reduction in blood pressure was gradual but progressive over 4 hours and the pattern of response was uniform. No significant adverse effects related to the treatment were found. Only basic measurement of pulse and blood pressure was considered necessary and so this regimen of therapy is suitable for general use even when sophisticated monitoring facilities are not available and staff levels are limited.